Summary: When the Integrator's Daphne White, CHTP observed the February 26, 2009 US Senate hearing on integrative healthcare chaired by Senator Tom Harkin (D-IA), she chose to focus on Harkin's introductory comments in which he calls for an "end to discrimination against alternative healthcare practices." White then reviews the comments of the sterling panel of Oz, Weil, Ornish and Hyman.The odd point is that Harkin and Mikulski, after specifically focusing both of the week's hearing on "integrative healthcare" - language preferred at the parallel IOM Summit - Harkin announces an interest in changing the name of NCCAM to "National Center for Integrative Medicine." White has captured a provocative dialogue. Has our time actually come? What time is it? We've got a challenge to make sure Harkin and his colleagues get that right.

Integrator readers are blessed to have a convergence of our heated interest in national policy action, and the desire of Beltway resident, professional reporter and Healing Touch Practitioner Daphne White, CHTP to explore the ideas and strategies that are emerging in the integrative healthcaer world. This is the second of White's dispatches from the front, following her Report on Mikulski's US Senate Hearing on Principles of Integrative Health, Feb 23.

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Time to End Discrimination against Alternative Health Care Practices,Sen. Harkin Says; Practitioners Must Lobby Congress to Make it Happen

By Daphne White, CHTP

Daphne White, CHTP

It was not your
usual Senate hearing. Testifying on
behalf of integrative medicine before Senators Harkin, Mikulski and Enzi at the
Senate HELP Committee were four leading physicians: Mehmet
Oz, Dean Ornish, Andrew Weil and Mark Hyman.
Testifying on behalf of the status quo was … no one! That’s an unusual set-up on Capitol Hill,
where panels are usually set up to represent “both points of view.” Lobbyists for the medical establishment were
present to watch the proceedings and plot their next steps, but they didn’t
have a seat at the table. Not this time,
anyway.
By any measure, it
was a watershed week. The Feb. 26 HELP Committee hearing was the
second in four days to focus on integrative medicine. And the very next day, Sen. Harkin traveled across
town to the Institute of Medicine, to address the 500-strong Institute of Medicine National Summit on Integrative Medicine and the Health of the Public.
Harkin told both groups that the time
has come to "think anew" and to "disenthrall ourselves" from the dogmas and
biases that have made our current health care system in so many ways wasteful and "dysfunctional. ” He borrowing some quotes from President Lincoln’s 1862 address
to Congress. “It is time to end the
discrimination against alternative health care practices. It’s time for America’s health care system to
emphasize coordination and continuity of care, patient-centeredness, and
prevention. And it’s time to adopt an
integrative approach that takes advantage of the very best scientifically based
medicines and therapies, whether conventional or alternative.”
Speaking to the
IOM Summit on Friday, Harkin said, “I have just four words for you: Our time has come!” He added that IOM visitors to Washington might think “it looks like the same old Washington,
but it’s not.” Yet Harkin warned
the IOM participants that the real work of serious health reform is still ahead
of us. “Just because what we’re talking
about here is the most common sense, most cost-effective kind of medicine
doesn’t mean it’s a done deal,” he said.
“Nothing in Washington is a done deal.” Even though the “status quo is broken and wasteful”
to the tune of $2.1 billion, Harkin said, “the ‘stagnant quo’ is still” very
powerful and very much alive. “There are
forces that will defend allopathic medicine with all their power,” Harkin said. “It’s human nature.”

“I’m just
wondering, how do we
harness you all in advising us
and advising the
President?

“We just have to figure out
how
to integrate you into the
health care reform debate.”
-- Harkin to his panel

“We pay trillions
for surgery but peanuts for prevention,” he added, noting that only 5 cents of
every health care dollar is spent on prevention. “We are happy to pay for amputation” for
diabetes patients, but there is almost no re-imbursement for nutrition and
prevention. “The time has come to think
of outcomes and quality, and to reimburse for that,” Harkin said.But Harkin said he
can’t bring about this revolution in health care reform and reimbursement on his
own. “I will do everything I can to
include integrative medicine in the health care reform bill,” he said. “But I can’t do it alone. I need each and every one of you here to go
home and be real health evangelists
for health reform.” Integrative practitioners
must take the message of integrative and preventive health to their places of
worship, to civic leaders, to their friends and everyone else they know, Harkin
said.
“I need you to
make appointments with your Congressmen and your Senators, either here in Washington or in your
home districts,” he said. “This reform won’t just happen. We have to get people around the country to demand this change. Seize the day” and make it happen he
said. Contact information for all the
Senators is here and Congressmen can be located here.

Regarding the $1-billion for
effectiveness research

Apparently, there is nothing
in the stimulus package language
requiring
that CAM treatments
be included. Harkin was “afraid”
this money would be used simply
to compare one kind of
allopathic
treatment against another.

Harkin is clearly
looking for active partners in this health care reform effort. In the middle of the Senate hearing, he had asked
Ornish, Weil, Oz and Hyman: “I’m just
wondering, how do we harness you all in advising us and advising the
President? How can I put you in great
positions of power so you can” help make decisions about the needed
reforms?

“How can you get
us involved?” Ornish responded. “Ask
us! We’ve been waiting for this opportunity
for a long time!” Ornish added that he
had once naively assumed that good research was the key to reforming
medicine. But research alone doesn’t
cut it, he said. “We need to change the
re-imbursement system. We are all here
to help you. Just ask!” Responded Harkin, “we just have to figure out
how to integrate you into the health care reform debate.”
The next day at
the IOM Summit, Harkin took the time to answer questions from the floor, and I
asked whether part of the $1.1 billion he appropriated for comparative
effectiveness research in the stimulus bill could be used to study the
effectiveness of CAM treatments. Harkin had indicated at the Senate hearing
that he was “afraid” this money would be used simply to compare one kind of
allopathic treatment against another.
Apparently, there is nothing in the stimulus package language requiring
that CAM treatments be included, but Harkin
was receptive to the suggestion.
Harkin
didn’t
mince words at the Senate hearing in an impromptu assessment of NCCAM,
an
office that he spearheaded and funded through the Senate Appropriations
Committee. “One of the purposes of this
center was to investigate and validate
alternative approaches,” he said. “Quite
frankly, I must say publicly that it’s fallen short. The focus, quite
frankly, has mostly been on disproving rather than seeking out and
improving” alternative therapies.
The next day,
Harkin told the Summit that he thought the time
has come to rename NCCAM: instead of the
National Center
for Complementary and Alternative Medicine it should be called the “National Center for Integrative Medicine,” he
said. Previous to his arrival, there had
been much discussion at the Summit
about the need to move away from the concept of “integrative medicine” and toward
“integrative health care,” a term

“Why not call it the National Center
for Integrative Health Care?”
someone asked Harkin. He seemed
to agree, and wrote down the
suggestion on his notes at the podium.

more inclusive of non-physicians. “Why not call it the National Center
for Integrative Health Care?” someone asked Harkin. He seemed to agree, and wrote down the
suggestion on his notes at the podium. “Let’s disentangle from the status quo and get
health care reform done right this time,” he said.

The question is
whether those who attended the Summit
will take the enthusiasm home with them, and take time off from their practices
to actually begin lobbying and agitating for change. Those who are profiting from the current
broken system -- the AMA, health insurance companies, big Pharma – will be
spending hundreds of thousands (and
possibly millions) of dollars to make sure their “voice” is heard. Their “First Amendment right,” as the
spokesman for the Chamber of Commerce so poetically put it, will be amply
represented.
Who will speak for
us? Don’t look to the right or the
left: there is nobody there! If you want to make sure that integrative
health care is really included
in this health care reform effort, you’re going to have to put the sweat equity
in yourself. If we don’t get ourselves,
our clients, our friends and colleagues organized now, we’ll have no one to
blame but ourselves.

As Hillel once said: “If I am not for myself, who will be for me?
If I am not for others, what am I? And if not now, when?”

Comment: I am thinking that if a psychologist were analyzing this moment he or she would find deep bipolarity in it, or perhaps quadripolarity. It's odd. There is the Prophetic Ecstasy: "Our time has come!" Then of course, the "stagnant quo" is still all-powerful. Backed-up against this is the

Is the popular power of Oz, Weil
and the rest
of the panel being
organized by anyone? If not,
we're still out in the desert,
screaming to ourselves,
that
our time has come. Hurray for us!

seeming inability of Harkin, who was key in creating the $1-billion effectiveness research program in the stimulus package, to allow integrative healthcare to be explored under it. What? Third, one of integrative medicine's key scientific leaders is asking Harkin to ask us what to do rather than understanding that the way this game works is that you organize and go in with a plan for how to be involved and then make your asks, and make your donations as well. Ask not for your Country to can ask you what to do, ask for what you want to do for your country. Harkin is clear about what's needed: basic grassroots organizing. Is the popular power of Oz, Weil and the rest of the panel being organized by these leaders? By the Bravewell? By anyone? If not, we're still out in the desert, screaming to ourselves, that our time has come. Hurray for us!

Then there is the potentially ugly mis-step of the name change proposal from NCCAM to National Center for Integrative Medicine (NCIM). This would be a step backwards. We would thus centralize this version of healthcare alternatives in a single medical guild which has a crappy history of sharing. That this isn't empty talk. Case in point: Take a listen to the hearing. Check whether any of the MD speakers even note the licensed complementary and alternative healthcare practitioners on whose backs this movement was based. (And I challenge any of them to a debate on whether or not what i have asserted is so.) All favor including conventional allied health practitioners who were in their club prior to the advent of this entire dialogue. And c'mon, the focus we need is on health. Let's put it in the name. Credit the voice from the crowd who suggested National Center for Integrative Health Care.

Those with long memories
will known that the
Clinton
reform effort included many
health-focused, paradigm-
shifting ideas that went
nowhere. I remember.
I fell for them.

I see two clear goal emerging for organizing. One is to make sure that, if there is a name change at NCCAM, it is a name that underscores the paradigm shift to health and the diversity of professions involved in leading the effort toward health. The second is the push to create on Office of Wellness to gain some foothold for this concept and not have it drift off as an dried up artifact of the early days of the Obama heaklth reform. Those with long memories will known that the Clinton reform effort, 15 years gone, included many very sublime and fetching, paradigm-shifting ideas, that went nowhere. I remember. I fell for them.

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